Individual
DR. ELISABETH OLIVER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
544 S SAN VICENTE BLVD, SUITE 203, LOS ANGELES, CA 90048-4622
(323) 850-0620
Mailing address
1558 N OGDEN DR, LOS ANGELES, CA 90046-2616
(323) 850-0620
(323) 850-0620
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12291
CA
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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